croup management Flashcards
When should all children with croup be considered for admission?
Consider admitting all children with moderate or severe illness.
What are the symptoms of mild, moderate, and severe croup?
Mild: Seal-like barking cough, stridor, Sternal/intercostal recession at rest. Moderate: Same as mild plus agitation or lethargy. Severe: Same as moderate plus additional severe symptoms.
When should children with croup be admitted due to impending respiratory failure?
Admit if there is minimal barking cough, increasing upper airway obstruction, sternal/intercostal recession, asynchronous chest wall and abdominal movement, fatigue, pallor, cyanosis, decreased level of consciousness, or respiratory rate >70.
What is the management for all severities of croup?
All severities of croup should be treated with oral dexamethasone (0.15 mg/kg).
What should be done if oral medication is not possible for croup management?
If oral medication is not possible, use inhaled beclomethasone (2mg) or IM dexamethasone (0.6mg/kg).
What is the management for mild croup?
Hospital admission is not required for mild croup. Provide safety net advice.
What safety net advice should be given to parents of children with mild croup?
Advise parents to take the child to the hospital if continuous stridor is heard or the skin between the ribs is pulling in with every breath. Call an ambulance if the child is very pale, blue, or grey for more than a few seconds, unusually sleepy or not responding, having a lot of trouble breathing, upset while struggling to breathe and cannot be calmed down quickly, or unable to talk, drooling, or having trouble swallowing.
What is the management for moderate croup?
Oxygen should be administered for moderate croup.
What is the management for severe croup?
Oxygen should be administered for severe croup, and nebulised budesonide and nebulised adrenaline (1 in 1000 (1mg/ml)) should be given.
What should be done in severe cases of croup where respiratory failure occurs?
Intubation and ventilation should be considered in the minority of cases where respiratory failure occurs.
How should the diagnosis of croup be explained to parents?
Explain that croup is a common infection of the airways.
What advice should be given regarding the course of croup and the effect of steroids?
Explain that croup typically gets better over 48 hours and steroids have been given to help that.
What should parents do if their child’s croup symptoms get worse?
Advise parents to come back if the child’s symptoms get worse.
What should parents do if their child with croup becomes blue or very pale, unusually sleepy, or has serious breathing difficulties?
Advise parents to call an ambulance if the child becomes blue or very pale for more than a few seconds, unusually sleepy or unresponsive, or has serious breathing difficulties.
What can be given to a distressed child with croup?
Paracetamol or ibuprofen can be given if the child is distressed.
summarise croup management
